- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $2,691.53 / $8,317.64
| Facility | | $724.44 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $575.44 / $575.44
| Facility | | $575.44 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $57.54 / $57.54 / $57.54
| Facility | AS | $57.54 | $57.54 | $57.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,344.23 / $8,317.64
| Facility | | $616.60 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $660.69
| Facility | | $389.05 | $389.05 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $323.59 / $467.74
| Facility | | $323.59 | $323.59 | $467.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $676.08 / $4,265.80
| Facility | | $144.54 | $676.08 | $4,265.80 |